Caring for Mastectomy Scars: Healing Tips and Scar Treatment Options

Understanding Mastectomy Scars and How to Care for Them

A mastectomy is a surgery to remove all or part of the breast tissue as a treatment for breast cancer. While a necessary procedure for many breast cancer patients, it leaves behind scars on the chest that can be a source of discomfort or self-consciousness for women.

Mastectomy scars come in different shapes and sizes depending on the type of mastectomy procedure. A total or simple mastectomy removes the entire breast and leaves a scar across the chest. A modified radical mastectomy removes the entire breast and some axillary lymph nodes, resulting in a longer scar. A partial or segmental mastectomy removes only part of the breast and leaves a smaller scar.

Like any scar, mastectomy scars tend to be reddish-pink in color at first. Over time they will fade and lighten but never completely disappear. Proper care and treatment however can help minimize and improve the appearance of mastectomy scars.

Causes of Problematic Mastectomy Scars

While some degree of scarring is inevitable after a mastectomy, certain factors can contribute to more extensive, thicker, or discolored scarring:

• Genetics - Some people are just prone to developing thicker scars due to their genetics.
• Age - Older skin tends to scar more than younger skin.
• Tension - Excess tension across the incision line can cause wider scars.
• Infection - Infections after surgery can interfere with the healing process and cause worse scarring.
• Radiation - Radiation therapy often follows mastectomy and can worsen scar tissue.

Tips for Caring for Mastectomy Scars

While the severity of scarring differs from person to person, there are things you can do to help minimize and improve the appearance of mastectomy scars:

Moisturize diligently

Keeping the skin well-moisturized helps scars heal optimally. Apply a gentle, fragrance-free moisturizer like Cetaphil or Cerave twice a day to help soften and smooth the scar tissue and improve elasticity.

Use silicone scar treatments

Silicone scar gels, sheets, or bandages can help flatten and smooth mastectomy scars while allowing them to hydrate and breathe. Products like ScarAway Silicone Scar Sheets are worn over scars to help flatten and fade them.

Massage the scars

Gently massaging scars helps break up scar tissue and keeps them smooth. Use a moisturizer or vitamin E oil to massage the scars using firm but gentle pressure.

Wear sunscreen

Sun exposure can darken scar color and interfere with healing. Be diligent about wearing sunscreen on the mastectomy scar area when outdoors.

Consider scar creams

Over-the-counter hydrocortisone creams containing ingredients like vitamin E or onion extract can help improve scar appearance. Check with your doctor before using.

Know when to seek treatment

If scars become raised, thickened, painful, or very restricting of movement or range of motion, see your doctor about possible steroid injections or scar revision surgery to improve appearance and function.

What to Expect During Mastectomy Scar Healing

Healing from a mastectomy and dealing with the resulting scar tissue takes time. Here’s a general timeline of what to expect:

1-2 weeks after surgery

• Scars will likely be reddish and somewhat swollen or raised.
• Some drainage from incisions is normal. Keep clean and dry.
• Discomfort and tightness along the incision line is common.
• Scars may feel hard due to underlying swelling and fluid.

2-6 weeks after surgery

• Scar color starts lightening to a pinkish hue.
• Swelling goes down and scars become less raised or puckered.
• Scars may feel tight across the chest.
• Can start gentle scar massage at 4-6 weeks post-op.

2-3 months after surgery

• Scar color continues to improve to a lighter pink.
• Scars have a flatter, smoother texture.
• Scar massage helps improve elasticity.
• Can start using silicone scar sheets or gels.

4 months to 1 year after surgery

• Scars keep fading to a lighter color.
• Scar massage can be done regularly to keep scars flexible.
• Scars are less noticeable and restrictive.
• Sunscreen should be used regularly on scars when exposed.

Remember, scars can take a year or longer to fully mature. With regular moisturizing, massage, and sun protection, most will continue to gradually improve in appearance over time.

Dealing with Pain and Sensitivity of Mastectomy Scars

Mastectomy scars are located across the chest area, which can be a sensitive region both physically and emotionally after breast cancer surgery. Some common issues include:

Pain

Scar tissue may be painful to the touch in the early weeks and months after surgery. As nerves regrow and swelling goes down, sensitivity usually improves. Massage and silicone sheets can make scars less painful.

Numbness

Lingering numbness is common after mastectomy since surgery damages nerves in the chest skin. For some this numbness improves over time. Protect scars from injury since numb areas lack sensation.

Tightness

Scar tissue lacks the elasticity of normal skin. Gentle stretching and range of motion exercises can improve flexibility over time. This tight, tethered feeling often lessens as scars mature.

Itching

Itchy, uncomfortable scars are common as the incisions heal. Moisturizing helps relieve itchiness. Avoid scratching as it can worsen scar appearance.

Tenderness

Scars may remain tender to touch or pressure long after surgery. Silicone scar gel often relieves mastectomy scar tenderness. A supportive bra or camisole also helps.

Emotional distress

Viewing mastectomy scars can be an upsetting reminder of cancer for some women. Connect with support groups and therapists to help adjust to changes in your body and self-image after surgery.

When to Seek Treatment for Scar Issues

In most cases, mastectomy scars will continue to mature and improve gradually on their own as long as proper scar care is followed. However, seek medical attention if you notice:

• Signs of infection - redness, heat, swelling, oozing of incision sites
• The scar becoming very raised, thickened or keloid
• Extreme tightness or limitation in range of motion in the chest, arms or shoulders
• Chronic pain or tenderness in the scar area
• A widening or spreading of the scar over time

If mastectomy scars are causing significant discomfort or restriction that impacts your quality of life, discuss the available treatment options with your doctor such as:

• Steroid injections to flatten thick, raised scars
• Physical therapy to improve mobility and range of motion
• Laser scar revision to resurface and minimize scars
• Surgical scar revision for severe, wide, or restrictive scarring

Coping Emotionally With Mastectomy Scarring

Along with the physical changes that come with mastectomy scars, there is often an emotional component as well. Losing a breast to cancer and seeing the scars left behind can negatively impact a woman's body image and self-confidence.

Be patient with yourself as you adjust to the changes in your body. Some tips for managing the emotions linked to mastectomy scarring include:

• Joining support groups to connect with other women who understand what you are going through.
• Considering breast reconstruction surgery to restore breast shape.
• Focusing on gratitude for your health rather than mourning your losses.
• Reminding yourself daily of your strength, courage, and resilience.
• Making self-care and self-compassion a priority during recovery.
• Seeking counseling or therapy if struggling with self-esteem.

While mastectomy scars symbolize a battle fought and won against cancer, they can still be challenging to accept and adjust to emotionally. Give yourself plenty of time to heal both physically and mentally. Know that you are still beautiful, strong and brave with or without visible scars.

In Summary

A mastectomy leaves scars that can pose both a physical and emotional challenge for breast cancer survivors. Proper moisturizing, massage, sun protection and silicone treatments can help minimize and fade mastectomy scars over time. Let your doctor know if you experience significant pain, tightness or other issues from scar tissue so they can suggest appropriate treatment options. Be patient and take good care of yourself as you heal. With the right approach, these scars will improve and you can feel comfortable in your own skin again.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.